Diabetes Management

What you need to know about managing your diabetes.

DIABETES: A BIG PROBLEM IN AMERICA

Diabetes affects about 1 in 10 Americans and pre-diabetes (also known as insulin resistance) affects about 1 in 3 Americans. If you haven’t been diagnosed as having diabetes, of if your physician has told you that you have “borderline” diabetes, or if you’ve had gestational diabetes during pregnancy then <strong>know that your vascular health relies on your ability to control your blood sugar.

Our philosophy regarding diabetes and vascular disease is simple here at Allegheny Vein and Vascular: we want you to keep your toes, legs, and feet attached to your body! While we are adept at revascularization and will do everything possible to maximize the ability for your vascular system to provide oxygen-rich blood to your feet and legs, we CANNOT do it alone. We need YOU to do everything you can to participate in the management of your diabetes or pre-diabetes.

KNOW YOUR RISK FOR DIABETES

Unsure if you’re at risk for diabetes or pre-diabetes? Use the CDC’s PreDiabetes Screening Tool:

If you’re at risk, how can you minimize developing diabetes?

The first thing you must consider is changing your relationship with food. Drastically reducing high-carbohydrate foods like grains, potatoes, and sugars from your diet, as well as artificial sweeteners which have been linked to increased insulin resistance when consumed over time is where you should begin. Also, limit the amount of fruit you are consuming — be mindful of your serving size — and choose fruits that are low on the Glycemic Index scale, such as berries.

Next, understand how carbohydrates work. Carbs are processed by your body into sugar, causing you to release more insulin (which doesn’t work the way it should) and makes you hungrier. Yes, your your body will crave MORE carbohydrate-rich foods, so you end up adding MORE sugar… and it’s a vicious cycle! Now, if you instead choose to swap out the high-carb craving for something high in fat and protein (which will satisfy you over the long haul) your body will have to produce LESS insulin because there is LESS sugar for it to trigger that release. This is what you want to see.

NOTE: While we appreciate that changing your relationship with food may seem daunting, if avoiding the development of diabetes is your goal then know that we believe that you can do it! You need to believe it, too.

Maintain a Healthy Weight... and Exercise!

Maintaining a healthy weight is critical to successfully reducing the risk for diabetes. If you’re overweight, losing 5-7% of your body weight can delay the onset of diabetes. For example, if you weigh 200 lbs, your weight loss goal would be to lose 10-14 lbs, then have your risk reassessed. Focus on filling your plate with non-starchy vegetables, protein, and minimally-processed healthy fats and you’ll have an easier time controlling your weight.

Get on the move! Experts recommend moving your body for at least 30 minutes of physical activity each day. You should discuss the best activities suited to your physical needs with your physician, create a plan, and stick to it. Think outside the box, and don’t forget that even if you’re alternatively ambulating with a wheelchair, walker, or scooter, that your health care provider can assess your ability to perform physical activity from a seated position and recommend activities that address any limitations.

If you’ve already been diagnosed with type 2 diabetes, now what?

Again, you’re going to need to change your relationship with food — stat! Follow the dietary guidelines we just discussed (previous section). Weight loss and management of your blood sugars are the critical components in this equation, helping you to have control over your health and wallet. Insulin and diabetes medications are expensive!

The last thing you want to do is to eat carbohydrates with reckless abandon and throw more and more medication at a problem that originates with your food intake. Instead, solve the underlying issues by addressing what you put into your body. Doing so means that you’ll have to use less and less medication as you get your diabetic condition under control Many can even eliminate the need for diabetic medications altogether!

Know your A1c Value / Glycated hemoglobin A1c

As a diabetic, one of best indications we have to gauge your recent blood sugars is a blood test called “Glycated hemoglobin A1c”, or A1c for short. This gives us a snapshot of the last 3 months of your body’s ability to get glucose into the cells so that it may be used as fuel. Diabetics should always know their last A1c value and when that blood test was taken. Carry that info in a notebook, calendar, or smartphone to bring with you to your appointments because we will definitely ask you for it! Diabetics with vascular disease should aim to have an A1c value at or below 6% to maximize vascular health.

How does diabetes and pre-diabetes affect vascular health?

Consider this example.  If you spill a drink containing sugar on your countertop and let it dry for a bit, you will be left with a sticky surface, right? This is exactly what having too much sugar (glucose) in your bloodstream will do to your red blood cells.

THIS SECTION/TRANSITION NEEDS HELP

Your smallest arteries are called capillaries. Capillaries are essential in delivering oxygen-rich blood to cells. Think of it this way. The large vessels that come off of your heart send large amounts of blood to a body region, like a highway direction: north to the head, neck, and arms, or south to the abdomen, pelvis, and legs. Within each of these regions are slightly smaller vessels that work like a two-lane highway delivering oxygen to smaller and smaller vessels, until you’re on a one-lane walking trail that is much like a capillary. Capillaries feed small amounts of cells, and when one or two of them get blocked off it’s not a big enough impact to show any symptoms. However, if enough of these capillaries get blocked and die off, entire sections of tissue will be starved of oxygen and you will begin to show signs of ischemia (also known as dead or dying tissue or gangrene).

Other Complications Resulting from Diabetes

Many people with diabetes also suffer from diabetic neuropathy, also called “diabetic nerve damage” that usually affects the legs and feet. The affected nerves will signal incorrectly, and will either deaden the sensation or feeling (most often in the bottoms of the feet) or will signal sensations of pain, burning, or tingling in the affected area. This is especially dangerous in diabetics that have lost the sensation in the bottoms of their feet.

NOTE: It is highly recommended that diabetics wear well-fitting, hard-soled shoes or slippers at all times when walking around or ambulating via wheelchair or scooter.

STAY ON TOP OF POTENTIAL FOOT ULCERATION!

Critically important for you to know is that more than 85% of lower extremity amputations that occur in diabetics are caused by a non-healing foot ulceration. Therefore, diabetics must be vigilant in monitoring their feet on a regular basis for potential trouble.

Daily inspection of your feet can allow you to discover any potential problems or new wounds that should be evaluated by a vascular professional right away. It is important to look at the top and bottom of each foot, but also to look for any dark spots below callouses or tender areas over the bones on the side of the foot, heel, or ball of the foot. Make sure to look between each toe for wounds or fissures that can occur with dry skin.

For more information on how to properly examine your feet, please watch the short video on the sidebar that further explains foot examination.

If you find a new wound on your foot, call us right away. Time is of the essence and the sooner your wound can be evaluated and treated, the faster you’ll be on the road to healing.

ALL THINGS VASCULAR

A great place to learn about all things vascular.

Take time to learn about the vascular system and how it functions.

Learn about venous and arterial vascular conditions that affect the body.

Explore treatments & procedures offered through Allegheny Vein & Vascular.

Learn about the examinations and testing protocols vascular patients receive.